Postsplenectomy Gastric Deformity

Gastric deformities may be observed following splenectomy. Ansel and Wasserman found mass- or polyplike deformities, most commonly in the posterolateral wall of the gastric fundus in 7% of postsplenectomy patients [36]. They ranged from 1.5 to 4.5 cm in diameter, and from small submucosal-appearing defects to larger polypoid masses simulating neoplasms (Fig. 3.39). These defects may vary in etiology but are postulated to be related to ligation of the short gastric vessels between the spleen and greater curvature of the gastric fundus, with resulting infolding of the stomach wall. Other postulated causes are local trauma with edema and/or hematoma, and foreign body suture granuloma.

Figure 3.39. Postsplenectomy gastric deformity. Single view from a double-contrast upper GI series shows a smooth lobulated filling defect in the gastric fundus after splenectomy for lymphoma. Biopsy showed no tumor.

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